The present invention is generally directed to a healthcare management system. The healthcare management system includes a framework of databases, proxies, services, processors, a front end Healthspace service Application Programming Interface (API) or Healthspace framework (used interchangeably herein) using a web service and internet gateway to interconnect heterogeneous clients. The system not only interconnects various service providers and clients but also provides methodologies for measuring efficiency and providing incentives, suggestions, and means to improve the performance and efficient utilization of healthcare services by consumers and service providers. Still further, the system provides for relationship based security and methods for increasing effectiveness of communicating healthcare information.
The U.S. healthcare system is the most costly in the world. Healthcare is out of control in America. There are many providers of healthcare who each have their own proprietary system for maintaining client records, client medications, billing, and claims. Every person has a detailed medical history that could be relevant to future diagnoses and to the treatment of potential problems, yet all of the various practitioners are separate and maintain different records that are proprietary, incompatible, unconnected and generally inaccessible. Health costs are rising and a large portion of this is due to inefficient use of healthcare. Some inefficiencies include the disconnected nature of practitioners and clients, the lack of cooperation between practitioners, the inappropriate use of brand named drugs as opposed to generic drugs, a general apathy on the part of the client and also, in large part, due to lack of accurate information presented to clients or patients. Of the information that is out there and that is indeed broadcast accurately to relevant patients, there is a tendency for these people to just ignore or not be motivated to change their behaviors to increase their health or efficient user of their healthcare benefits. People are inundated with so much junk mail and spam, solicitations, and advertisements that the only way to cope is to block out a large portion of this as noise and unwanted and throw it away or ignore it.
So there exists a need to interconnect all of the different medical practitioners with billing and insurance adjustment, prescription providers, the end-user, client, patient, or consumer, and also to inform them of better practices and effectively communicate with them to motivate them to change behavior to be more healthful and efficient in use of funds, medicines, and benefits. Still further, there exists a need to ensure access to records is constrained solely to authorized entities.